A Retrospective Analysis Of Pituitary Function Of151Cases Of Patients After Single Nostril-transsphenoidal Surgery For Pituitary Adenoma

[Objective] To investigate the value of pituitary hormone level in diagnosing pituitary adenoma,to evaluate the postoperative pituitary function via single nostril-transsphenoidal approach and analyze the corelative factors influencing the function,in order to guide the clinic diagnosis and treatment of pituitary adenoma.[Methods] A total of151patients with pituitary adenoma admitted in our unit from Sep.2008to Sep.2011were analyzed retrospectively. Postoperative pituitary function and predictive influencing factors including gender, age, course, tumor size, preoperative pituitary hormone level, removal level and endocrine function type were investigated. The data were dealt with t-test,χ2test and multivariate Logistic regression analysis. So as to evaluate the preoperative pituitary hormone level in diagnosing pituitary adenoma and distinguish the influencing factors of postoperative pituitary function.[Result] The highest diagnosis coincidence rate was obtained when taking serum PRL>69.48ng/ml as diagnostic criteria in the preoperative diagnosis of Prolactinoma.107cases (70.9%) obtained total removal of the tumor,32cases (21.2%) obtained subtotal removal of tumor and12cases (7.9%) obtained most removal.101cases (66.9%) got normal postoperative antepituitary function. The univariate analysis demonstrated that age, endocrine function type, special type (based on preoperative pituitary hormone level) and removal level were significantly related to postoperative antepituitary function. The multivariate Logistic regression analysis showed that special type (OR=20.699,P<0.05),and removal level(P<0.05) were the independent influencing factors affecting the postoperative antepituitary function after single nostril-transsphenoidal surgery.By means of pairwise comparison of removal level, we found that differences between total removal and most removal and differences between subtotal removal and most removal were statistically significant (P<0.0167),while, differences between total removal and subtotal removal were not statistically significant.77cases (51.0%) got postoperative posterior pituitary dysfunction. The univariate analysis demonstrated that among the seven factors aforementioned only tumor size associated with postoperative posterior pituitary function (P<0.05).Pairwise comparison of tumor size showed only differences between pituitary microadenoma group and giant pituitary adenomas were statistically significant(P<0.0167).[Conclusion] A high diagnosis coincidence rate could be obtained when taking serum PRL>69.48ng/ml as diagnostic criteria in the preoperative diagnosis of Prolactinoma. Preoperative pituitary hormone level and removal level are independent influencing factors affecting the postoperative antepituitary function after single nostril-transsphenoidal surgery. Tumor size associated with postoperative posterior pituitary function.Intensive,normative and individualized treatment treatment of pituitary adenomas should be taken according to the above factors.So as to deal with the tumor and save as much pituitary functions as possible,and improve the quality of patients’ life.